73 m(2)). Correlations of NT-proBNP levels with hemodynamic and prognostic parameters (time to clinical worsening and overall survival) were assessed. Overall, GFR correlated inversely with NT-proBNP and
had the strongest influence on NT-proBNP levels in a stepwise multiple linear regression model including hemodynamic parameters and age (r(2) = 0.167). PH patients with renal insufficiency had significant higher levels of NT-proBNP (median: 1935 ng/l vs. 573 ng/l, p = 0.001). Nevertheless, NT-proBNP correlated with invasive hemodynamic parameters in these patients. Using higher cut-off values than in patients with preserved renal function, NT-proBNP levels were significantly associated with time to clinical worsening ( bigger than 1660 ng/l, p
= 0.001) and survival ( bigger than 2212 ng/l, p = 0.047) in patients with renal insufficiency. Multivariate GSK2879552 purchase Cox’s proportional hazards analysis including established prognostic parameters, age and GFR confirmed NT-proBNP as an independent risk factor for clinical worsening in PH patients with renal insufficiency (hazard ratio 4.8, p = 0.007). Thus, in a retrospective analysis we showed that NT-proBNP levels correlated with hemodynamic parameters and outcome regardless of renal function. By using higher cut-off values, NT-proBNP seems to represent a valid clinical selleck compound marker even in PH patients with renal insufficiency.”
“We hypothesized that wastewater leaching from on-site sanitation systems to alluvial aquifers underlying informal settlements (or slums) may end up contributing to high nutrient loads to surface water upon groundwater exfiltration. Hence, we conducted a hydro-geochemical study in a shallow sandy aquifer in Bwaise III parish, an urban slum area in Kampala, Uganda, to assess the geochemical processes controlling the transport and fate of dissolved nutrients (NO3, NH4 and PO4) released from on-site sanitation systems to groundwater. Groundwater was collected from 26 observation wells. The samples were analyzed for major ions (Ca, Mg, Na,
Mg, Fe, Mn, selleck chemical Cl and SO4) and nutrients (o-PO4, NO3 and NH4). Data was also collected on soil characteristics, aquifer conductivity and hydraulic heads. Geochemical modeling using PHREEQC was used to determine the level of o-PO4 control by mineral solubility and sorption. Groundwater below the slum area was anoxic and had near neutral pH values, high values of EC (average of 1619 mu S/cm) and high concentrations of Cl (3.2 mmol/L), HCO3 (11 mmol/L) and nutrients indicating the influence from wastewater leachates especially from pit latrines. Nutrients were predominantly present as NH4 (1-3 mmol/L; average of 2.23 mmol/L). The concentrations of NO3 and o-PO4 were, however, low: average of 0.2 mmol/L and 6 mu mol/L respectively.